Pancreatic Cancer Treatment Explained

Most patients with pancreatic cancer have a type known as adenocarcinoma, which occurs in the area of the pancreas responsible for producing enzymes or proteins for digestion.¹ Adenocarcinoma can be treated in a variety of ways, with treatment selection depending on factors related to the patient and their cancer.

Pancreatic cancer treatment may include surgery, radiation therapy, chemotherapy, immunotherapy, targeted therapy, and supportive care. Patients may receive 1 treatment or a combination of these treatments.² A team of medical professionals, including medical oncologists, surgeons, radiation oncologists, and gastroenterologists, will work together to help manage patient care.³

Surgery

Surgery to remove pancreatic cancer may be an option for the 20% of patients who are diagnosed when tumors are small and contained within the pancreas.⁴ The type of surgery performed depends on the location of the cancer within the pancreas. The surgeon may remove all or part of the pancreas, as well as portions of nearby organs such as the small intestine, stomach, spleen, or gallbladder.⁴

Surgery may also be used to improve symptoms, such as pain or digestion difficulties, in patients whose tumors cannot be safely or completely removed.⁴

Radiation Therapy

Radiation therapy is the use of high-energy radiation to kill cancer cells.⁵ It may be given to shrink cancer before surgery, after surgery to kill remaining cancer cells, as combination treatment with chemotherapy, or to decrease pain caused by cancers that cannot be removed with surgery. Radiation therapy sessions last only minutes and are not painful, but patients can experience side effects of nausea, loss of appetite, diarrhea, and fatigue in the weeks following treatment.⁵

Chemotherapy

Chemotherapy is a type of treatment given to kill cancer cells throughout the body.⁶ Cancer cells grow and divide rapidly to make more of themselves, and chemotherapy works by stopping this cycle. Side effects occur with chemotherapy, because some healthy cells also grow and divide rapidly. Cells in the bone marrow, blood, hair, digestive tract, and reproductive tract are most likely to be affected.⁶

Depending on pancreatic cancer stage and overall health, chemotherapy may be recommended alone or in combination with surgery, radiation, or targeted therapy.⁷

First-line therapy is the chemotherapy chosen for the first round of cancer treatment. For patients whose cancer continues to grow after first-line therapy, some choose to receive a second round of chemotherapy or second-line chemotherapy.⁸

Immunotherapy

Immunotherapy is used to help a patient’s own immune system fight cancer.⁹ Immunotherapy medications are being researched to use in combination with other treatments. At this time, most immunotherapy treatments for pancreatic cancer are only available through clinical trials.⁹

Targeted Therapy

Targeted therapy is medication designed to harm cancer cells while leaving healthy cells unaffected.¹⁰ Currently, targeted therapy is available for patients with unresectable (not removable) pancreatic cancer for use in combination with other treatments.¹⁰

Supportive Care

Palliative and supportive care refer to the therapies designed to maximize quality of life for patients affected by a serious medical condition, such as pancreatic cancer.¹¹ Instead of targeting pancreatic cancer itself, supportive care aims to provide relief from symptoms and treatment side effects.¹¹

References

1. American Cancer Society. What is pancreatic cancer? www.cancer.org/cancer/pancreatic-cancer/about/what-is-pancreatic-cancer.html. Last revised February 11, 2019. Accessed November 13, 2019.
2. Pancreatic Cancer Action Network. Treatment types. www.pancan.org/facing-pancreatic-cancer/treatment/treatment-types. 2019. Accessed November 20, 2019.
3. American Cancer Society. Treating pancreatic cancer. www.cancer.org/cancer/pancreatic-cancer/treating.html. 2019. Accessed November 20, 2019.
4. Pancreatic Cancer Action Network. Surgery. www.pancan.org/facing-pancreatic-cancer/treatment/treatment-types/surgery. 2019. Accessed November 20, 2019.
5. Pancreatic Cancer Action Network. Radiation therapy. www.pancan.org/facing-pancreatic-cancer/treatment/treatment-types/radiation-therapy. 2019. Accessed November 20, 2019.
6. Pancreatic Cancer Action Network. Chemotherapy. www.pancan.org/facing-pancreatic-cancer/treatment/treatment-types/chemotherapy. 2019. Accessed November 20, 2019.
7. National Cancer Institute. Pancreatic cancer treatment (adult) (PDQ^®)–health professional version. www.cancer.gov/types/pancreatic/hp/pancreatic-treatment-pdq. Updated November 12, 2019. Accessed November 13, 2019.
8. Hua J, Shi S, Liang D, et al. Current status and dilemma of second-line treatment in advanced pancreatic cancer: is there a silver lining? Onco Targets Ther. 2018;11:4591-4608.
9. Pancreatic Cancer Action Network. Immunotherapy. www.pancan.org/facing-pancreatic-cancer/treatment/treatment-types/immunotherapy. 2019. Accessed November 13, 2019.
10. Pancreatic Cancer Action Network. Targeted therapy. www.pancan.org/facing-pancreatic-cancer/treatment/treatment-types/targeted-therapy. 2019. Accessed November 20, 2019.
11. American Cancer Society. What is palliative care? www.cancer.org/treatment/treatments-and-side-effects/palliative-care/what-is-palliative-care.html. Last revised May 10, 2019. Accessed November 21, 2019.